The ethics of medicine are guided by the Hippocratic Oath which commits medical professionals to the principle of health care based on, Primum non nocere -- First do no harm. Health professionals are speaking out on behalf of the public health of their patients as hydraulic fracturing, otherwise known as fracking is introduced into their communities.

Fifty years ago this month Rachel Carson wrote Silent Spring a book that warned of the devastating impacts of pesticides and pollutants on human health. That seminal book led to the formation of the EPA and catalyzed a ban on DDT. Decades after the publication of Carson’s book the alarm has escalated with fracking, a technology that is forging a global gas initiative of extreme extraction. Many of the potential human rights injustices are being ignored by governing agencies, as extreme fossil fuel is being fast tracked locally and internationally.

Environmental scientist and biologist Sandra Steingraber (and founder of New Yorkers Against Fracking) referred to as a contemporary Carson asks this,“Is fracking going to kill more New Yorkers than it employs?” She continues to be outspoken about the human rights issue of the “crime of contamination” as she shares her own story of being a cancer survivor struck with bladder cancer at the age of 20 in her environmentally-polluted town in Illinois where she grew up.

Her story is resonating across New York where it was recently announced that Governor Cuomo will not be making an imminent decision about whether to begin high-volume horizontal fracking in the Southern Tier of New York State, but instead has ordered a health study to be completed. As Mary Esch reported for the AP:

New York’s health commissioner and ‘qualified outside experts’ will review the health impacts of shale gas drilling before a moratorium on the ‘fracking’ extraction process is lifted, Department of Environmental Conservation Commissioner Joe Martens said Thursday.

Martens said he has rejected calls from health and environmental groups for a health impact analysis by a university school of public health or other independent group, saying such a review is the job of government. Martens said he’s asked Health Commissioner Nirav Shah to assess DEC’s own health impact analysis.

Although community groups worry that the study won’t be conducted by an outside, independent body, many are relieved that the multitude of health risks associated with the process of fracking has now become central in the NY debate of how to proceed.

Pressure groups are concerned though about connections between the government and industry. The Environmental Working Group (EWG) sued the Cuomo administration for documents that would show “how the state has drafted its plan to permit high volume hydraulic fracturing and horizontal drilling for shale gas.” In the EWG press release they state, “…the Cuomo administration failed to honor EWG’s request under the state’s Freedom of Information Law for full disclosure of public records showing communications between the governor and six other senior officials and about two-dozen representatives of the oil and natural gas industry.”

While New Yorkers wait for the study, the process of shale gas development is already impacting people, whether by exploration, production, distribution and storage to name only a few of the aspects of this full-scale industrial activity. When one reads the reports, the testimonials, meets people suffering and sees the statistics on the chemicals it becomes clear that the only ethical choice and one that supports social justice is to begin an independent Health Impact Assessment, an HIA that addresses the cumulative health impacts.

Jill Wiener representing the 10,000 member volunteer citizens group, Catskill Citizens for Safe Energy said, “New Yorkers are rightly concerned about the serious health impacts that would accompany the fracking industry’s march through the Marcellus shale. It’s hard to have confidence in a health study that will be overseen by the Cuomo Administration and the DEC considering the DEC has produced an environmental impact statement that ignores peer reviewed science in favor of mis-information obtained from industry websites. Is the Administration really concerned with the health impacts of fracking NY or with covering their ‘legal obligations’ so fracking can commence?”

And the health impacts could be severe. Dr. Sheila Bushkin has been an active member of the Medical Society of the State of New York (MSSNY) for 14 years, in addition to being the of Director of the CME Program Committee of Physicians, Scientists and Engineers for Healthy Energy (PSE) and she shared a Table of 12 known chemicals associated with fracking that have dangerous impacts on health. These chemicals include, arsenic, benzene, lead and phenol with symptoms including Leukemia and lymphoma, renal failure, pulmonary damage and the list goes on illuminating the seriousness of the threats to public health.

Nadia Steinzor, the Marcellus regional organizer for Earthworks Oil & Gas Accountability Project, an organization that is working on a health survey study now in Pennsylvania addressed the risks of the entire process of gas development. Steinzor says, “Most people are getting sick from facilities which include wells but is not exclusive to wells. There are compressor stations and compoundment pits and some of the earliest cases we’ve seen of health impacts out west were from very shallow vertical drilling. So health threats are not exclusive to horizontal drilling. It is a question of scale and deep shale drilling is an extremely large industrial process increasing the health risks. It’s what drilling used to be on steroids. The oil and gas industry has reigned supreme in our politics for a really long time and 90% of oil and gas wells are fracked today.”

The Pennsylvania Alliance for Clean Water and Air has a growing “List of the Harmed” as case studies are being compiled about the illnesses people are suffering that they feel are connected to shale gas development.

The list of people who’ve been affected by fracking is long and growing – here are some of them who’ve been brave enough to speak out:

On May 1, 2011 Charles Edward Bevins III, 23 was killed on a drilling site in Smyrna, New York. I spoke with his mother, Nancy Bevins and his sister Charlotte Bevins who shared the story of his death. When we met they were holding signs that said, “A life lost in the rush to drill” and there was a photograph of him holding his infant son and his daughter.

Nancy Bevins: We want to show that this is more than the water and the air; this is affecting people’s lives.

Charlotte Bevins: We’re from West Virginia and he was working for a small drilling company contracted by Norse Energy and they were working up in New York. The freeze months had just been lifted by the company, even though the ground was still in very bad condition. But they were pushed to move forward and even asked for safety equipment, which was denied because they were told it wasn’t in the budget. As a result my brother’s life…

Nancy Bevins: He was pinned between a forklift and a building because the forklift fell off the mat and into the soft ruts of deep mud. The man driving the forklift didn’t even have an operator’s license or training.

Charlotte Bevins: Is it that important to do this so quickly and get it out of the ground that the people working on sites aren’t being protected? The politicians are in bed with the industry and not protecting the workers, us, and anyone.

Nancy Bevins: The gas has been there for millions of years. It’s still going to be there in another million. Why is there such a rush now and why are our politicians not moving towards clean energy and things that aren’t so dangerous? In West Virginia so many people work in the industry and lots in other states. We have friends who are working 16 hours and then having to drive home four states away. They are just running these young men into the ground.

Charlotte Bevins: My brother was told when they were drilling, using the fracking fluids, they were told it’s soap. Another employee shared that his boss spent the day in the ER even though they tell us this stuff isn’t hazardous. Look, I want them to have permanent safe jobs so they don’t have to worry about if they’ll even come home to their family. I feel so angry and bitter right now that the only choice I have is to speak out and advocate for the workers.

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Natalie Brant has vertical fracking near her home just outside of Buffalo NY and her water has gone bad. The gas company started fracking near her home about 3 years ago in Springville, NY, which is about an hour from Buffalo. She’s had health problems with her children and has been sharing her story carrying suitcases of her contaminated well water.

Natalie Brant: My water has gone bad and my house can blowup. We purchase around a 100 gallons of water a week so we can bathe in it and cook with it. I have 8 children and they’ve all had to go through brain scans every few months and heavy metals testing constantly. My son has asthma that came on suddenly and all kinds of upper respiratory infections constantly. I tracked this, his health problems and all of my kid’s illnesses became strong three weeks after they began the process of hydro-fracking behind my home. People are just leaving their homes, all of the money they’ve invested in them and they are being forced to walk away from it. So we need Andrew Cuomo, our governor, to have backbone and to stand up to this gas and oil industries and tell them to get out of New York State. We need this banned immediately, if not the State of New York will end up going bankrupt.

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Matthew Manning: My name is Matthew Manning and I live in Franklin Township in Susquehanna County, Pennsylvania. This [holding a container of murky water] is what the gas company did to my water on December 7, 2011. Shortly after they drilled my water turned gray and filled with methane. They say it’s safe but I don’t believe it. I only have a 1/3 of an acre and the nearest gas well is 4,000 feet behind my house.

When we bought the house in November of 2010 we had no problems with our water. It’s not just us that have this problem, many homes in the area that also the same day their water went bad, turned gray and their wells filled with methane. I just bought the house, I have 15 years left to pay on it and it’s worthless. The water has extremely high barium levels, manganese, selenium, ethane, aluminum and iron levels that are 10 times higher than the safe limits. I didn’t have that before, they say it’s safe but it’s not. I have a lawsuit against the gas company, WPX (Williams) now. What do you do? I have a house that I owe $120,000 on. This has to stop before we; all of us have no more water to drink.

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Larysa Dyrszka is a retired pediatrician and has been doing public health advocacy work on behalf of children at the United Nations and now in upstate New York since she moved to the Catskills seven years ago.

Sabrina Artel: What is the impact of fracking on children?

Larysa Dyrszka: Well, children are different from adults in so many ways. I have done some research on what some of the health impacts are and putting together what we know about children’s metabolism, there is reason to be concerned.

First of all, children are breathing faster, they are closer to the ground so they may be exposed to ground level ozones more readily and endocrine disruptors much more easily impact them. We know that a large percentage of the chemicals used throughout the entire cycle of gas drilling are in the category of endocrine disruptors. Because their respiratory rate is faster they inhale a greater amount of air and whatever the pollutant is or toxin. In addition children’s metabolism is different. They have to drink more, they eat more per body weight and so anything that is in the water or in the food is going to impact them more because they’ve taken in a greater amount of toxins. They also pick up things and chew on them so you have to be very careful that the soil they are playing in is clean.

Artel: Is fracking safe?

Dyrszka: That is a huge issue that finally at least is being acknowledged by the Department of Environmental Conservation. Those yes, there are health impacts that need to be addressed. We’ve been through letters of advocacy to Dr. Shaw and Governor Cuomo we’ve been asking for an analysis of the health impacts but the process is very important. We haven’t seen the 67,000 comments that were written for the second SGEIS but we know a lot of them were comments on health issues.

So there’s going to be a review of this by the DOH, which as far as we’re concerned the Department of Health should have been an involved agency, a co-lead agency from the very beginning. Fracking is going to have large, unprecedented public health implications and they should have been at the table from the beginning. Yet they have maintained that the SGEIS, the 2011 draft had addressed health impact adequately. So now to put this responsibility on a DOH that has maintained that everything is just fine, for them to do a health ‘review’ now really doesn’t seem to compute that they will now change their minds. They have maintained this whole time that there are no impacts caused by fracking that haven’t been addressed and that it’s perfectly safe.

Artel: As a retired pediatrician how does fracking and the health threats affect doctors and their patients?

Dyrszka: That’s a very good question because many physicians have not been introduced to this topic and the doctors on the ground, in many organizations are expressing concern. That includes the 6,000 pediatricians in the American Academy of Pediatrics in District 2, which is all of NY State, the Medical Society of the State of NY, the NY State American Family Physicians, American Nurses Association of NY, the University of Rochester School of Medicine, the Healthy Schools Network, and many other concerned physicians.

As a doctor, I join thousands of my medical colleagues in calling on NY State Governor Cuomo, his DEC and the Department of Health in particular, to be advised by an independent and transparent health impact assessment as a profession of their dedication to true science.

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Ramsay Adams is the executive director of Catskill Mountiankeeper an environmental organization based in Youngsville, NY. CMK has been pushing for a Health Impact Assessment (HIA) since 2008.

Artel: What’s your reaction to Cuomo’s statement last week that he wants to look at the relationship between health and fracking before making a decision in NY?

Adams: It’s very heartening that the Governor understands the need to look at health and how it relates to fracking. The issue now is who does the Health Impact Analysis and are they going to do a full independent health analysis in the proper sense of the term? So far the governor has indicated that he wants to keep it in house and have the Department of Health do the study with the DEC and that’s not what we want.

We want an independent health impact analysis. It’s a well-established tool that is used in these kinds of situations to accurately assess health threats. Anything short of that is going to be suspect and that’s the point here, we want the governor, we want the DEC and the health community to have access to an analysis that isn’t tainted by the influence of industry. Unfortunately the DEC and the Department of Health and other state agencies are being heavily influenced by the industry at this point. The message is twofold, we are heartened that the governor has taken the step to look at health but in order to do that and to really stand on independent analysis that is free from industry and for that matter advocates influence, it needs to be a proper Independent Health Analysis.

Artel: What are your concerns about fracking in NY?

Adams: The key to understanding the implications for health and fracking is to look at the full life cycle of the process. Everything from development, to extraction, to distribution and then to burning of the fuel. So in order to understand what to think you have to look at the entire life cycle of fracked gas and that’s where you see the compounding problems with health and the environment that make it so dangerous. We know about the herbicides and pesticides to prep a site, the toxic chemicals, the industrialization, the leakage, the air pollution, the methane but the dangers to the workforce are very significant, that gas kills workers exposed to these chemicals.

The key is you can’t just look at the fracking. Fracking is one part of getting dirty fuel extracted and to market. When you start to see the cumulative impacts you realize you have a real human health issue on a huge scale for a lot of people: in the gaslands, the distribution and for the workers. Also for the emergency workers, the firemen, and the hospital workers; it just goes down the line and that’s the key to understanding the impacts on health the whole entire life cycle of this process needs to be looked at.

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Cindy Kurpil Gieger is a Sullivan County Legislator in the Catskills.

Artel: What’s your concern as a legislature regarding the health impacts of fracking?

Gieger: As an elected official my number one responsibility is to protect the health and safety of the people I represent. As a former Public Health nurse and victim of the devastating results of water contamination and resulting litigation, I must call for a comprehensive health impact study inclusive of health care professionals across NYS and the nation.

Until recently NYS has not looked at the implications of health in regards to the process of hydrofracking for natural gas drilling. In the process of hydrofracking in other areas of the nation serious concerns have been raised in regards to chemical exposure and disease processes in those areas. As a former Public Health nurse and one whose family was involved in litigation against a major gas company due to MTBE water contamination, I am well aware of the effect of chemical exposure and the health of our citizens.

Artel: What kind of litigation were you involved in?

Gieger: Twenty years ago, my loved one and almost a dozen young adults were diagnosed with Multiple Sclerosis after it was proven in Westchester Supreme Court, that indeed the water had been contaminated. Although proven, a statute of limitations prevented the gas company from bearing any financial responsibility and kept their record clear of this incident. The claims that the gas companies have no record of water contamination is true due to citizens, even through class action lawsuits, being unable to make these companies bear record of these incidences.

Artel: What is your reaction to Governor Cuomo’s and the DEC’s statement that they will not due an independent study but have the Department of Health (DOC) review the health impacts?

Gieger: As far as NYS conducting a Health Impact Study and NOT allowing independent health professionals/studies, this will not be a full impact study due to the fact that current methods of disease study is limited. When the NYS DOH for example releases a health study they rely on limited sectors of the population and limited disease processes. This was evident in their release of a 20-year study following the incident that affected my family. Included in the study were only numbers for leukemia in men and lung cancer in women. There is not to my knowledge an inclusion of studies to include neurologic disease including auto- immune disease, which are the first diseases one should study and look at when studying the health effects of chemical exposure.

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Mary Menapace: I’m Mary Menapace, a registered nurse, born where the infamous shale outcrops are located, in the town of Marcellus. I now live in Skaneateles. I am a mother, wife and nurse. I have three college-age daughters.

I work at Upstate Medical University in the Women’s Services Department, OB/GYN clinic.

Artel: How did you get involved in the issue of health and fracking?

Menapace: I got involved with the issue when I read about HVHF (High Volume Hydraulic Fracturing) Operations, as used in this general permit, about three years ago. At the end of the day, billions of gallons of water have morphed into billions of gallons of toxic radioactive waste. I’ve been trying ever since to figure out how that makes sense. I have attended scores of forums: legal, industry, medical, water, air, political and have read anything I can find on the subject. I have travelled to PA east and west and have seen a lot of NY State, especially the Southern Tier chasing informational forums.

Artel: When did you first find out about fracking and the possibility of HVHF in your community?

Menapace: There are ten wells within three miles of our home, drilled in 2006 by Chesapeake. None of them are online, they are all shut in. There’s no pipeline to them although, there is to one nearby. We saw the drilling, very impressive not knowing anything back then. The Seismic, rigs, stadium lights, trailers and trucks. Now those leases are held at a pittance, fifteen bucks an acre.

Artel: What’s your concern?

Menapace: My concern is with the build out, the whole shebang. But the waste is the big one…billions of gallons of toxic radioactive waste introduced into the human environment is the irrefutable problem. It starts as water, but the act of fracking the rock releases all those toxins…VOCs, heavy metals, salts and radioactivity. And those toxins become airborne with storage, processing and transport and soil borne with injection and spill. Those toxins get into the blood and tissue, lungs eyes and skin of humans, and animals, causing illness, injury and even death.

As a nurse I am trusted to be a health advocate, to be a confidante and advisor on healthcare decisions. If I worked in PA, if a patient had a drilling exposure, I could not find out the chemicals used without signing a nondisclosure agreement. To which I would be bound not to tell the patient nor my fellow doctors and nurses. I could not work under those bounds.

I know folks are suffering; I have talked to people from WV, PA, CO, NM, OH and WY who have suffered illness and whose animals have died. Their stories are systematically buried when they ought to be compiled. The governmental agencies, i.e., the DEP in PA and the DEC here [in New York], are underfunded and overworked. Time and again I have heard there is no place to go, to report, to test, to get advice, to get treatment and remediation and to get help.

The agencies issuing the permits are the ones enforcing the rules and promoting the resource is their task.

What we have is an extremely powerful industry that pierces and poisons our landscape, is given a pass on regulatory laws for massive volumes of hazardous waste and they are allowed to bury their stories of harm as it goes.

As a mother and a nurse and a lifelong resident of the Finger Lakes, I object.

I support no more subsidies for oil and gas. I support right now no more shale gas dollars allowed. I support wind, water, solar, biogas and other alternatives big but preferably small, moving forward. I support a healthy earth, and a thriving and sustainable economy that is frack free.